Action Points

The majority of fast-food kids' meals and kids' meals at full-service restaurants met the national recommendation of containing 600 or fewer calories, according to data from national top fast-food and full-service restaurants.

Note that less than one-third of fast-food meals for kids and less than one-quarter of full service restaurant kids' meals also met national recommendations for fat, saturated fat, and sodium content.

Restaurants are doing better at keeping the calories in kids' meals down, but they need to work harder at reducing fat, saturated fat, and sodium, researchers said.

The majority of fast-food kids' meals (72%) met the national recommendation of containing 600 or fewer calories. So did most of the kids' meals at full-service restaurants (63%), according to a study conducted by Christina Economos, PhD, of Tufts University in Boston, and colleagues.

However, less than one-third of fast-food meals for kids also met national recommendations for fat, saturated fat, and sodium content. For full-service restaurants, it was less than one-quarter, the researchers said in the Journal of Nutrition Education and Behavior.

"Restaurants should be commended for their progress to date, but no single step will reverse the childhood obesity epidemic and there is still much work to do," Economos said in a press release. "We need to combine more nutritious children's meal offerings with stronger education to drive both supply and demand to support healthier choices," Economos said.

"From a pediatrician's perspective, this is good to know about. Pediatricians can help parents by reminding them that many restaurants do have healthier meal choices. That's one way of helping to make this process smoother," Stephen Daniels, MD, PhD, of the University of Colorado in Aurora, said in an interview with MedPage Today. Daniels chairs the American Academy of Pediatrics committee on nutrition.

Top 20 Restaurants Evaluated

Economos and colleagues used the Nation's Restaurant News 2014 Top 100 Report to identify the top 10 fast-food and top 10 full-service restaurants that offered a kids' menu, made nutrition information publicly available, and provided calorie information for all children's entrees. The investigators then compared this information with dietary guidelines from the U.S. Department of Health and Human Services.

In particular, the researchers looked at whether the kids' meals met the recommendations for calorie count (600 or fewer), calories from fat (35% or less), calories from saturated fat (10% or less), and sodium content (770 mg or less).

The average kids' meal at fast food restaurants contained 506 calories, 31% of calories from fat, 9% of calories from saturated fat, and 863 mg sodium.

"The current findings present encouraging information about the availability of lower-calorie kids' meals ..." the investigators said. "However, the consistently low availability of meals meeting all four nutrition criteria of interest and varied availability of these meals across restaurant chains suggest that healthier children's meals are not currently the norm."

"The study does a nice job of characterizing what healthier options are available. That's an important piece of the puzzle but not the whole puzzle. The availability of healthier options doesn't necessarily mean those meals are ordered or eaten, and that is a key issue," Daniels told MedPage Today.

The healthier menu items need not only to be available, but to be prominently displayed and marketed in some way. If restaurants offer healthier options but don't promote them, kids may not choose them, and then the restaurants could claim they were not successful and take them off their menus, Daniels said.

Right now, it's not clear if kids are ordering and eating the healthier meals, Daniels said. "Those data are hard to come by. We don't have good information on that. That's something we need to understand better for sure."

The study was funded by the Robert Wood Johnson Foundation and The JPB Foundation.

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